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General NPI Number Information
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NPI Number | 1609641083
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Entity Type | Organization
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Legal Business Name | INNERWAVE HEALTH LLC
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 28 VALLEY RD STE 1
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2709
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Country | US
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Telephone | 201-565-0979
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Fax |
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Provider Business Mailing Address
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Address Line | 28 VALLEY RD STE 1
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2709
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | LING CHEN
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Credential | APN
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Telephone | 201-565-0979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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